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<head>
<meta http-equiv="Content-Type" content="text/html; charset=utf-8" />
<title>user form</title>
</head>

<body>

<form action="user-apply.php" method="get" name="user-apply">
<table>

<tr><td>First Name</td><td>:</td><td><input name="f-Name" type="text" /></td></tr>
<tr><td>Middle Name</td><td>:</td><td><input name="m-Name" type="text" /></td></tr>
<tr><td>Last Name</td><td>:</td><td><input name="l-Name" type="text" /></td></tr>
<tr><td>Gender</td><td>:</td><td><select name="Gender">
      <option value="Male">Male</option>
      <option value="Female">Female</option>
    </select></td></tr>
    
<tr><td>Country Of Current Residence</td><td>:</td><td><input name="current-residance" type="text" disabled="disabled" value="kuwait" placeholder="Kuwait" /></td></tr>
<tr><td>Data of birth</td><td>:</td><td><select name="DOB-d">
      <option value="0">Day</option>
      <option value="1">1</option>
      <option value="2">2</option>
      <option value="3">3</option>
      <option value="4">4</option>
      <option value="5">5</option>
      <option value="6">6</option>
      <option value="7">7</option>
      <option value="8">8</option>
      <option value="9">9</option>
      <option value="10">10</option>
      <option value="11">11</option>
      <option value="12">12</option>
      <option value="13">13</option>
      <option value="14">14</option>
      <option value="15">15</option>
      <option value="16">16</option>
      <option value="17">17</option>
      <option value="18">18</option>
      <option value="19">19</option>
      <option value="20">20</option>
      <option value="21">21</option>
      <option value="22">22</option>
      <option value="23">23</option>
      <option value="24">24</option>
      <option value="25">25</option>
      <option value="26">26</option>
      <option value="27">27</option>
      <option value="28">28</option>
      <option value="29">29</option>
      <option value="30">30</option>
      <option value="31">31</option>
    </select> <select name="DOB-m">
      <option value="N/A">Month</option>
      <option value="Jan">Jan</option>
      <option value="Feb">Feb</option>
      <option value="Mar">Mar</option>
      <option value="Apr">Apr</option>
      <option value="May">May</option>
      <option value="Jun">Jun</option>
      <option value="Jul">Jul</option>
      <option value="Aug">Aug</option>
      <option value="Sept">Sept</option>
      <option value="Oct">Oct</option>
      <option value="Nov">Nov</option>
      <option value="Dec">Dec</option>
    </select> 
    <select name="DOB-y">
      <option value="0">year</option>
      <option value="2015">2015</option>
      <option value="2014">2014</option>
      <option value="2013">2013</option>
      <option value="2012">2012</option>
      <option value="2011">2011</option>
      <option value="2010">2010</option>
      <option value="2009">2009</option>
      <option value="2008">2008</option>
      <option value="2007">2007</option>
      <option value="2006">2006</option>
      <option value="2005">2005</option>
      <option value="2004">2004</option>
      <option value="2003">2003</option>
      <option value="2002">2002</option>
      <option value="2001">2001</option>
      <option value="2000">2000</option>
      <option value="1999">1999</option>
      <option value="1998">1998</option>
      <option value="1997">1997</option>
      <option value="1996">1996</option>
      <option value="1995">1995</option>
      <option value="1994">1994</option>
      <option value="1993">1993</option>
      <option value="1992">1992</option>
      <option value="1991">1991</option>
      <option value="1990">1990</option>
      <option value="1989">1989</option>
      <option value="1987">1987</option>
      <option value="1986">1986</option>
      <option value="1985">1985</option>
      <option value="1984">1984</option>
      <option value="1983">1983</option>
      <option value="1982">1982</option>
      <option value="1981">1981</option>
      <option value="1980">1980</option>
      <option value="1979">1979</option>
      <option value="1978">1978</option>
      <option value="1977">1977</option>
      <option value="1976">1976</option>
      <option value="1975">1975</option>
      <option value="1974">1974</option>
      <option value="1973">1973</option>
      <option value="1972">1972</option>
      <option value="1971">1971</option>
      <option value="1970">1970</option>
      <option value="1969">1969</option>
      <option value="1968">1968</option>
      <option value="1967">1967</option>
      <option value="1966">1966</option>
      <option value="1965">1965</option>
      <option value="1964">1964</option>
      <option value="1963">1963</option>
      <option value="1962">1962</option>
      <option value="1961">1961</option>
      <option value="1960">1960</option>
      <option value="1959">1959</option>
      <option value="1958">1958</option>
      <option value="1957">1957</option>
      <option value="1956">1956</option>
      <option value="1955">1955</option>
      <option value="1954">1954</option>
      <option value="1953">1953</option>
      <option value="1952">1952</option>
      <option value="1951">1951</option>
      <option value="1950">1950</option>
      <option value="1949">1949</option>
      <option value="1948">1948</option>
      <option value="1947">1947</option>
      <option value="1946">1946</option>
      <option value="1945">1945</option>
      <option value="1944">1944</option>
      <option value="1943">1943</option>
      <option value="1942">1942</option>
      <option value="1941">1941</option>
      <option value="1940">1940</option>
      <option value="1930s">1930</option>
    </select> </td></tr>
    <tr><td>Visa Status</td><td>:</td><td><select name="visa">
      <option value="Transferable">Transferable</option>
      <option value="Non-Transferable">Non-Transferable</option>
      <option value="Tourist">Tourist</option>
    </select></td></tr>
    <tr><td>Marital Status</td><td>:</td><td><input name="Marital" type="radio" value="Single" /> <label>Single</label>  <input name="Marital" type="radio" value="Married" /><label>Married</label></td></tr>
    <tr><td>Driving License</td><td>:</td><td><input name="DrivingL" type="radio" value="yes" /> <label>Yes</label>  <input name="DrivingL" type="radio" value="no" /><label>No</label></td></tr>
    





</form>
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